A question about possible tearing???

Okay tommarow I will be at 34 weeks..and latley its been a little annoying, since everyone around me seems so critical about wanting a natural birth. Basically everyone (family and friends) except for my midwife and the woman in my pregnancy group, say that I cant do it, or laugh or just arent supportive I dont know how many times Ive heard your NOT gonna be able to do it!! But when I hear people say things to me about it, alot of thoughts cross my mind, the first being WHATEVER!! I CAN DO THIS, and the second being what if theyre right???..I really like this website, all the woman on hear have alot of supportive and positive things to say..which Im happy to see. The main thing I am REALLY afraid of is tearing...that one scares me the most I can handle the Idea of birthing my daughter naturally but Im scared that i'll rip...I imagine birth hurts already, but this will be my second child Im planning on a VBAC, ..I really want to do this..Does anyone have any advice on things to PREVENT TEARING?? I know things are never a guarentee, but any thoughts just to give me a little peace of mind??

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Just to tell you my experience, I had a homebirth with a midwife. My midwife did all she could to prevent tearing, but I did tear anyway and honestly I did not feel it. I was more scared about her stitching me up and that didn't hurt either. You are in such euphoria after having the baby that you don't even care. Just don't have it as a worry and ask your midwife what she does to prevent it. It will just give you peace of mind.

If you do tear, midwives can apply a medication to the area so that when you're being stitched up, you won't feel it. The other thing is that you'd be more likely to tear in a hospital, where the focus is on rush rush rush to get you out of the hospital so they can free up a bed for another woman. So the fact that you're going to be at home and take your time, letting your body do it's thing...as well as the fact that you won't be pushing on you back as women often do in hospitals, you'll be less likely to tear. It might happen, but the risks aren't as great as they would be if you weren't going to use gravity to help you get the baby out.

I also had tearing with my daughter, which I attribute to pushing too fast (it was the shoulders that did it!) and I didn't feel it either. In fact, I didn't really have any pain during the delivery at all, just the burning. If they didn't tell me I tore, I wouldn't have known at that point. It was a little uncomfy afterwards, but just getting in and out of bed or the car for a few days. It's a pretty regenerative area (more so than a c section scar, I imagine). I too was really scared of an episiotomy or tearing, but having been through it now, it's one of the least of my worries. As far as preventing them, there's a good write up on notjustskin.org about preventing tearing, and it's stuff you can start now like diet and perineal massage! Congrats to you!

There is quite a bit that you can do to reduce the likelihood of having a tear but sometimes it can depend on the position of baby, mom or just genes !

Labor in warm water as much as possible - labor at home as much as you can in your own bath. The warm water helps the tissues get nice and stretchy.

Perineal massage - it doesn't train your muscles to do anything but it gets you used to the sensation of the tissues opening and stretching gradually so that you don't tense up or push too hard. Those sensations are a feedback mechanism to S L O W D O W N.

Have your partner apply a warm compress to your perineum when you start to bear down (especially if you haven't been able to labor in water). It gives you a focal point and the heat blocks pain receptors and turns on heat receptors instead.

Birth in a position of your choosing.....try to avoid being on your back. Side lying gives you a lot more control especially if your baby is coming quickly.

Use an affirmation such as 'my baby emerges gently and easily' when you find this fear popping up.

I have been fortunate enough to not have had any tearing with either of my births. I attribute this to a few things.

First, perineal massage. I believe that it isn't recommended that you start until 34 weeks, so you're right on track. I used vitamin e oil and did it every night until I delivered.

Second, Evening Primrose Capsuls inserted in to the vagina once a day. It is my understanding that this method is a bit controversial because of the belief of some that it can cause labor.(I believe because of it softening agents) SO, ask your midwife/ob before doing this.

Third, waiting for the urge to push and then just relaxing in to the feeling instead of bearing down and pushing hard. For me there is a happy medium in pushing that feels really good. If I don't give in enough, it's VERY uncomfortable, if I push too hard, the same is true.

You could do all of these things, and still tear, but next time you start to think about it negatively, remind yourself that the stitches you MIGHT have to have if you tear are no where near what you had after a c section. Also, stay the heck away from people who aren't giving you positive feed back. If they are close to you politely tell them that you've made your choice and if they can't be supportive, that they are to avoid the subject all together with you.

I find it amusing(and pretty annoying) that when a mom has had a natural birth, she is bragging and talking down to other women if she shares her experience. But if a mom who has had a negative experience wants to rain on a woman's parade who wants to have natural childbirth, she's just being "honest". BULL.

I'm sorry you're hearing "can't" so much. Please try to ignore them, or avoid the topic altogether, and only listen to encouragers. You CAN do it!
Just wanted to be supportive and tell you not to be afraid of tearing. It really won't be something you will feel all that much if it does happen, and there have already been some great tips on how to prevent it. Please let your midwife know this is one of your concerns, because it is something she probably wants to prevent also.

Xochilt, I'm 37 weeks and also hoping to prevent tearing with my first. The tips from the other women on here have been very helpful for me so thanks for putting this out there. As for perineal massage, I've just blogged about my first dabbles with that, including a BabyWorld article that gives some tips on how to perform the massage. Check it out, hopefully it will prove helpful.

I do find the massage a tad awkward so if anyone has any other tips to share, please do!

Birth 1 was a hospital birth with a walking epidural, an on-my-back delivery, with a very tiny (Thank You) episiotomy.

Birth 2 was an emergency c-section for not laboring fast enough with twins in the hospital.

Birth 3 was a homebirth which was accidentally unassisted because the baby was faster than the midwife. I had a 1cm tear which did not require stitches, and I healed up just fine with small amount of itching and burning for about 2 weeks. Even if I had required repair there are currently studies which are recruiting women who are willing to try surgical glue instead of stitches, and I would have opted for that approach.

From what I understand the most important factor in preventing a tear is being able to birth in the position that you find most comfortable, and having your baby's head supported during crowning and throughout the last pushes. If you are standing, squatting, or sitting on someone's lap (birth chair, birth stool), you can support your baby's head yourself if you want. Your midwife may want to help direct your position and your pushing, and is the best person to discuss this with, especially if you'd like to have a birth where she is just there in case of a problem, and to monitor the baby's heart rate etc. I also discussed what the hospital policies and procedures were for a VBAC in case I needed to transfer, so I knew beforehand that I would decline having hands inside my uterus to check my scar from the inside and such.

That being said, just commit to laboring without drugs with the intention to deliver without drugs - as long as things are going well. I had a c/section so it was very important to me to avoid any drugs which would increase my risk of uterine rupture, and an epidural which would keep me in bed and would mask the pain which women feel in-between contractions which is a major warning for uterine rupture.

Some women, including myself, had enough pain (like strong cramps) that at some point we'd have loved an epidural if only they didn't come with the risks of slowing down your labor, making it hard for your baby to find the right position to be born, and increasing the risk of fetal distress as well as c/section. The nice thing is that towards the end the only time I had to think about pain relief was when I was not having a contraction. Once I got to the point that I actually wanted an epidural it would have been too late to get one anyway.

Also, my husband cannot feel the difference between before and after the birth, and neither can I, so even though my small tear was inconvenient, it really didn't matter in the long run, and was much more tolerable than another c/section in all ways.

I've been reading the new book by Denise Spatafora called Better Birth: The Ultimate Guide to Childbirth from Home birth to Hospitals, and I have to say that there is so much information in this book for whatever you want to do that I was floored! For instance, this is what she says about possibly tearing:

"While you are pregnant, you can work on preventing the need for an episiotomy by doing the following:
Practice daily squats to increase the flexibility of your perineal muscle and skin. Eat food that are rich in vitamins E, C, and A. You can also try frequent perineal massages with olive oil or an oil of your choice during pregnancy, as well as practice the Kegel exercises that are listed in the tool box."

She's written a whole "toolbox" of things every expecting mom should know.
Also:
"During delivery, you can avoid an episiotomy by abstaining from pain medication, so that you can feel when to stop pushing. Choose a birthing position in which you are not lying on your back, because that would slow the baby's delivery once his or her head is crowning. Hot water bottles or hot compresses during Stage 2
(of labor) may also help. Your doctor or midwife might know how to lift the baby out over the perineum and can instruct you on how to breathe properly between contractions so that an episiotomy is not necessary."

Basically you should definately get this book! There is a wealth of info in it, I've been following her for about four years now since I found out about her hypnobirthing classes called Born Clear. She gave birth to her two babies in a hot tub outside her house.

It's nice to know that there are steps you can take all along the way to create the birth you want to create.
I hope this helps you feel a bit more in control. You can do it!!! Don't let anyone tell you otherwise!!!
It reminds of of a favorite quote that Kris Carr uses on her site Crazy Sexy Life,
"whether you think you can or can't, you're right."
Always know that you CAN!
Best wishes!
Lazarus

That was one of my biggest fears. That and the possibility of pooping in front of my husband was really freaking me out :) Anyway some other the techniques we did before labor was to have my husband put a finger or two in me and gently press down and around to softly stretch the area. you can do it your self but its easier if your partner does it. Also my midwife used pure olive oil to massage the area while I was in labor. There are no guarantees because I did tear. However the tear was so small (although it didnt feel small when it happened of course) that it only would have needed 1 stitch. My midwife left it up to me if I wanted the stitch or not because she said it wasnt necessary. I of course opted out of the stitches if I wasnt needed. Good luck.

I am 33 weeks, planning a natural childbirth, and also receiving a lot of criticism about how I will not be able to go without medication. The holidays were brutal as I had so many conversations with relatives about it...I'd try not to get into it with them but somehow it always came up. A lot of people laughed at me, too, like I was naive for thinking I could do it. I must say, it did does do a number on my confidence, but I have to remind myself that I have assembled a great, supportive birth team and done everything I can to prepare. I'm sue you have also and other women do it...so why shouldn't we be able to??

I, too, would like to prevent tearing. Here's how I'm working on preventing it:

-do lots of squatting from now until the birth
-perineal massage daily with oil (google how to do it)
-make sure you have enough fat & oils in your diet
-drink lots of water
-listen to your body and push when you feel you need to and if you feel you need to. don't let anyone bark orders at you to push at certain times or for a certain amount of time. your baby will let you know what he/she needs.